OncoHealth · 1 day ago
Manager of Quality & Accreditation
United States
Full-time
Remote
Mid, Senior Level
5+ years expOncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the complexities of cancer through technology enabled services. The Manager of Quality and Accreditation is responsible for developing and sustaining the company’s quality management program and ensuring compliance with accreditation standards related to Utilization Management and Telehealth programs.
BiotechnologyHealthcareAppsInformation TechnologyHealth CareMedicalOncology
Responsibilities
Maintain a documented quality management program aligned to NCQA/URAC expectations including annual program descriptions, work plans, goals, metrics, evaluations, and executive reporting; lead cross‑functional policy & procedure governance (version control, approval cycles, attestation, staff education) ensuring alignment across UM and telehealth operations; oversee controlled document repositories and evidence libraries for audits and surveys
Oversee ongoing accreditation maintenance and cycles for NCQA UM and URAC UM and Telehealth, including gap assessments, evidence compilation, application/attestation packages, and survey coordination
Develop an annual risk‑based audit and monitoring plan (UM decision timeliness/notice accuracy, peer review, grievance/appeals, telehealth clinical protocols, accessibility, privacy/security interfaces)
Evaluate and monitor Company vendors for compliance with accreditation requirements
Promote adherence to standards for credentialing and recredentialing
Qualification
Required
Bachelor Degree required
Certifications: Certified Person in Healthcare Quality (CPHQ), Certified Provider Credentialing Specialist (CPCS) or National Association Medical Staff Services (NAMSS) membership
5-7 years experience in healthcare quality, accreditation, compliance or clinical operations within a payer entity, UM organization, telehealth company or similar entity
Hands-on experience preparing for or maintaining NCQA UM and/or URAC accreditations(s). Strong working knowledge of UM operations (e.g., criteria application, timeliness, notices, appeals) and telehealth operational quality (e.g., protocols, consent, tech reliability, patient safety)
Demonstrated experience designing and conducting audits, root cause analysis, CAP development, and performance improvement methods ideally within a technology-enabled healthcare organization
Experience with credentialing requirements, primary source verification, and NCQA credentialing standards
Excellent writing/communication skills. Comfortable working with data and metrics
Ability to synthesize evidence and present to executive and clinical audiences. Consummate team player with excellent judgment and interpersonal skills
Exceptional organizational skills and attention to detail
Ability to work independently, manage multiple priorities, and meet deadlines and ability to motivate and lead a diverse group of stakeholders to drive execution
Systems/Tools: Proficiency with MS Office Suite and dashboard/reporting tools, and experience with credentialing software, Council for Affordable Quality Healthcare (CAQH) ProView, NPPES National Provider Identifier (NPI) Registry and National Practitioner Databank (NPDB)
Benefits
Full benefit package on your first day
Company bonus
Company
OncoHealth
OncoHealth is a digital health company that focuses on navigating the physical, mental, and financial complexities of cancer care.
201-500 employees
H1B Sponsorship
OncoHealth has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)
2022 (4)
2021 (4)
Funding
Current Stage
Growth StageTotal Funding
$56.5MKey Investors
Arsenal Capital Partners,McKessonBaird CapitalOak HC/FT
2022-05-09Private Equity
2020-05-26Series C· $28M
2018-11-05Series B· $21M
Leadership Team
Rick Dean
Chief Executive Officer | Board Member
Cliff Culver
Chief Operating Officer
Recent News
Company data provided by crunchbase